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Sec.13.04 RIGHTSOFSUBJECTSOFDATA ' � ' ' Subdivisron I. Type ojdata The rights of individual on whom the data is stored or to be stored shall be as set forth rn this section. Subd.2. Injormallon required to be givex individuaL An indivrdual asked to supply private or confidentra!data concerning himself shall be informed oj (a)[he purpose and intended use ojthe requested dala within the collecting state agency,political subdivision,or statewrde system;(b)whether he may refuse or is[egally required to supply the requested data;(c)arry known consequence arrsing from hrs supplying or �efusing to supp/yprivate or cohfidential data;and(d)1he identrty ojother persons or entiJies authorized by state orfederal law to receive the data. This requirement shall not apply when an individual is asked to supply iirvestigative data,pursuant to section 13.82, subdrvisron 5, to a Imv enjorcement o�cer. The commissioner of revenue mav nlace the notice reourred under this subdrvision in the indivrdual rncome tax or Drooerty tax retund instructrons inslead olon those farms. Subd.3. Access to data by individuaL Upon request ton responsible authority,an individual shall be in,J'ormed whether he is the subject of stored data on individuals,and whether it is classifred as public,private or confidential. Upon hrs further request,an individual who is the subject ojstored private or public data on individuals shal!be shoivn the data without arry charge to him and,if he desrres,shall be informed oJ the content and meaning ojthal data. After an indrvrdual has been shown 1he private data and informed of i[s meaning, the data need not be disclosed to him for srx months thereafter unless a dispute or action pursuant to this sectron is pending or additiona!data on the indivrdual has been collected or created. The responsible authority shall provide copies o,J'!he private or public data upon request by the indivrdual subject oj the data. The responsible authority may require the requesling person to pay the actua!costs of making,cert�ing,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivrsion,or within frve days oJthe date of the request,excluding Saturdays,Sundays and legal holydays,if immediate compliance is not possible. If he cannot comply with the reguest wi/hin that time,he shal!so inform the individual,and may have an addrtionalfive days wrthin which to comply with the request,excluding Snturdays,Sundays and legal holidays. Subd.4. Procedure when data is noJ accurate or complet�An individua!may contest lhe accuracy or completeness oJpublic or private data concerning himself. To exercise this rrghl, an individual shall not�in writing the responsrble authority describing the nature of the disagreement. The responsible authorrty shcrl!withrn 30 days erther: (aJ correct the ddtafound to be inaccurate or incomplete and altempt to not� past recipients ojinaccurate or incomplete data,including recipients named by the individual;or(b)notr,J'y the individaal lhat he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement ojdrsagreement is included with the disclosed data. The detetmrnation of the responsrble authority may be appealed pursuant to the provisions oJthe admrnistrative procedure act relatrng t,o contesled cates. • . DATA PRIVACYADV/SORY • In accordance with M.S.13.04,Subd.2,'Righls of subjec[s of data';we would 1 ike to injorm you that your requestjor a permrt or license from the City of Orono or any of its departments may require you to furnish cer[arn prrvate or confrdential in1'ormation. You are notifred that: . 1. . The rnjormation you furnish wrll be used to determrne your qualificalron for�he permrt or license requested. � 2. You may refuse to supply data,but refusal may require that the City deny the permrt or license. 3. The rnformation may be shared wlth other local,s�ate or federal agencies�o the extent necessary to process the permi!or license. 4. Ifyour requested permit or license requires Council action to approve,some information may become publrc. 5. You have certain rights under M.S. 13.04(see jolloiving page)to review private data on yourself. 6. Your full name is reqaired to process this application or permrt. PLEASE PRIfVT First Middle Last . • Address Ciry S�are Zip Phone I understand my rrghts as sta�ed above. Signature !0 4